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Prescription for pulmonary emphysema asthenia

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					Prescription              for           pulmonary         emphysema




                   Prescription for pulmonary emphysema
               Composition: Tiantu (CV 22), Danzhong (CV 17), Taiyuan (LU 9) and Lieque (LU
               7). For the treatment of splenic asthenia and phlegmatic accumulation, Pishu (BL20),
               Fenglong (ST 40) and Weishu (BL 21) are added; for the treatment of Simultaneous
               asthenia of the lung and kidney, Taixi (KI 3), Shenshu (BL 23), Qihai (CV 6) and
               Feishu (BL 13) are added; for the treatment of pulmonary accumulation of phlegmatic
               heat, Feishu (BL 13), Chize (LU 5) and Fenglong (ST 40) are added.

               Source: Practical Compendium of the Clinic Therapy of Acumox compiled by Fu
               Qiang.

               Action: Strengthening the spleen and nourishing the kidney, purifying the lung and
               melting phlegm, stopping cough and easing asthma.

               Elucidation: Pulmonary emphysema, similar to "pulmonary distension", "cough" and
               phlegmatic fluid" in TCM, is usually caused by weakness due to prolonged disease
               and the attack of exogenous pathogenic factors. Pulmonary emphysema actually
               resulted from the combination of phlegmatic turbidity, blood stasis and retention of
               fluid. It is often a syndrome characterized by the asthenia of the primary aspect and
               sthenia of the secondary aspect. That is why in this prescription Tiantu (CV 22) and
               Danzhong (CV 17) on the conception vessel are selected. One of them is the confluent
               acupoint of qi and the proximal selection of them can soothe the chest to promote the
               flow of qi and melt phlegm to stop asthma. As to the selection of Taiyuan (LU 9) and
               Lieque (LU 7) on the lung meridian, the former one is the Yuan-Source point and the
               latter is a Luo-Connective point. The distal selection of these two acupoints can
               nourish the lung to descend qi and stop cough to ease asthma. These four acupoints,
               used in distal and proximal combination, are the main acupoints in this prescription. If
               the lung is attacked by phlegm due to the accumulation of dampness caused by
               splenic asthenia, Pishu (BL 20) and Weishu (BL 21) are added. The proximal selection
               of them is for strengthening the spleen and stomach. The distal selection of Fenglong
               (ST 40), Luoconnective point of the stomach meridian for eliminating phlegm,
               combined with the main acupoints, can strengthen the spleen to melt phlegm and
               descend qi to stop asthma. If the lung is very asthenic due to the impairment of the
               renal qi due to prolonged illness and cough, Taixi (KI 3), the Yuan-Source point of the
               kidney meridian, and Taiyuan (LU 9), the Yuan-Source acupoint of the lung meridian,
               are added for the enriching the renal qi. The addition of Shenshu (BL 23) and Qihai
               (CV 6) in anterior and posterior compatibility is for the reinforcement of the renal qi.
               Feishu (BL 13), located near the lung, is selected for the reinforcement of the
               pulmonary qi. The sufficiency of the renal and pulmonary qi will enable the upper
               part to perform its dominating functions and the lower part to perform its receiving
               functions so as to enable qi to descend and ascend. If the lung is frequently pyretic or
               attacked by summer heat and the turbid phlegm is transformed into heat which blocks



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               the lung, then Feishu (BL 13), the back Shu point of the lung meridian, and Chize (LU
               5), the He-Sea point of the lung meridian, can be added. The distal and proximal
               selection of these two acupoints can clear the lung and descend qi to stop cough.
               Fenglong (ST 40), the key point for melting phlegmatic turbidity, can be used to melt
               phlegm. The combined use of these acupoints with the main acupoints can clear the
               lung to eliminate phlegm and stop asthma to ease cough.

               Indication: The pulmonary emphysema. The main clinic manifestation of this disease
               is short of breath. At the early stage, dyspnea is only felt during working. At the
               advanced stage, it is felt after slight movement or even under quiet state. Each time
               when the secretion from bronchia is increased or infection has occurred, the
               symptoms of chest distress and dyspnea will be worsened. Under severe conditions
               other serious symptoms may be brought about, such as headache, cyanosis and
               somnolence, or even bucket thorax, weakened movement of breath, tremor of voice,
               low sound of respiration and weak beat of the heart detected in auscultation. With the
               complication of pulmonary and cardiac diseases, more serious symptoms may occur,
               such as cyanosis, dilation of the cervical veins, hepatomegaly and edema of the lower
               limbs. X-ray examination showed increased transparency of the pulmonary lobes,
               widening of the intercostal spaces and the lowering of the diaphragm to the level of 11
               the rib.

               Performance: Tiantu (CV 22) is needled perpendicularly 0.2 cun first, then the tip of
               the needle turns to the lower part posterior to the sternum and punctured 1 - 1.5 cun.
               Respiratory reducing technique is used and the needling is continued till asthma is
               attenuated.

               Danzhong (CV 17) is needled 0.3 - 0.5 cun toward the ensiform process. The
               respiratory reducing technique is used till the breath turns smooth.

               Taiyuan (LU 9) is needled 0.3 - 0.5 cun perpendicularly, avoiding radial artery. The
               rotating nourishing technique is used for 1 minute.

               Lieque (LU 7) is needled 1.5 cun obliquely. Rotating reducing technique is used for 1
               minute.

               Pishu (BL 20) and Weishu (BL 21) are needled 0.5 -0.8 cun, the nourishing technique
               characterized by lifting, thrusting and rotating is used.

               Fenglong (ST 40) is needled 1.5 - 2 cun slightly upward and the reducing technique
               characterized by lifting, thrusting and rotating is used for 1 minute.

               Taixi (KI 3) is needled 0.5 - 1 cun and the nourishing technique characterized by
               rotation is used for 1 – 2 minute.




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               Shenshu (BL 23) and Feishu BL 13) are needled 0.5 - 1 cun and the nourishing
               technique characterized by rotation is used for 1 minute. Moxibustion can be
               performed for 5 minutes after needling.

               Qihai (CV 6) is needled 1.5 - 2 cun and respiratory nourishing technique is used to
               direct the acu-esthesia to the thighs and to Zhongwan (CV 12) along the conception
               vessel for 1 - 2 minutes.

               Chize (LU 5) is needled perpendicul arly 0.8 - 1.2 cun and rotating reducing technique
               is used for 1 minute.

               Clinical material: Acumox therapy is proved effective in improving the symptoms of
               pulmonary emphysema. Liang treated 50 cases of pulmonary emphysema by
               moxibustion and cupping therapy. At the acute stage of occurrence, the acupoints
               selected for performing cupping were Feishu (BL 13), Dazhui (GV 14) and
               Dingchuan (EX-B1) on both sides. The acupoints selected for performing suspended
               moxibustion were Fenglong (ST 40), Chize (LU 5) and Zusanli (ST 36) on both sides.

               Each acupoint was performed for 5 minutes once a day. Seven times made up
               1 course of treatment. At the remission stage, the asthenia of the pulmonary qi was
               treated by selecting the acupoints of Dazhui (GV 14) and bilateral Feishu (BL13),
               Xinshu (BL 15), Dingchuan (EX - B 1), Pishu (BL 20) and Shenshu (BL 23)
               combined with Hegu (LI 4), Zusanli (ST 36) and Xuehai (SP 10) ; the asthenia of the
               nephrosplenic yang, the acupoints selected were Mingmen (GV 4), Dazhui (GV 14)
               and bilateral Pishu (BL 20), Xinshu (BL 15) and Dingchuan (EX - B 1 ) combined
               with bilateral Taixi (KI 3), Sanyinjiao (SP 6), Neiguan (PC 6) and Hegu (LI 4). Big
               Moxibustion Box made by the author was used to moxibust the acupoints on the back
               and the acupoints on the limbs were moxibusted suspendedly.

               This treatment was repeated once a day. Each year this treatment was done for 1
               month around the dog days and winter solstice respectively. The total effective rate in
               the treatment of pulmonary emphysema was 74 %. [Liang Cuiying, China Journal of
               Acumox, 1988, 8(2) :20]Mang et al. injected the extract liquid from the rabbit
               pituitary into the acupoints to treat 56 cases of pulmonary emphysema. The selected
               acupoints were: ① Tiantu (CV 22) and Feishu (BL 13); ② Danzhong (CV 17) and
               Zhongfu (LU 1 ) ; ③ Huagai ( CV 20 ) and Dingchuan (EX-B 1). If the constitution
               of the patient was weak, Zusanli (ST 36) was added. After the sterilization of the
               acupoints, the syringe needle of No. 5 was selected, absorbed 4 ml of the liquid and
               injected into the one group of acupoints. The other groups were injected accordingly.
               The injection was given twice a week and 6 weeks made up 1 course of treatment.
               The therapeutic result, the total effective rate was 71.4%. [Mang Lie et al. Inner
               Mongolian Journat of TCM, 1990, 9(1): 18]




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               Typical case: The patient was a woman of 34 who suffered from asthma for 15 years
               in the winter or cold weather. In recent half a year she was hospitalized for 4 times.
               The treatment of TCM and MM (modern medicine) did not relieve her problem
               completely. In recent 2 days her problem was worsened due to the attack of cold.

               The present symptoms were headache, somatic pain, aversion to cold, fever, cough,
               chest pain, serious asthma and inability to sleep. Examination found dyspnea,
               cyanotic lips, slight tumescence of the eyelids, slight congestion of the throat, dilation
               of the cervical veins, bucket-shaped thorax, asthmatic sound all over the lungs and
               tachycardia. X-ray examination showed increased transparency of the lung.

               Diagnosis: bronchial asthma and pulmonary emphysema. After 7 days treatment of
               TCM and MM, the improvement was not obvious. Then other therapy was stopped,
               vesiculating moxibustion were performed on Dazhui (GV 14) and Danzhong (CV 17).
               The next day the Subjective symptoms were improved. After 7 days of treatment, the
               patient could lie in a supine position and sleep 6 - 7 hours a day. All the symptoms
               disappeared after 10 days of treatment. A follow-up survey of 5 months found no
               relapse.

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